2020 Employee Benefits Open Enrollment Guide - Open Enrollment for the 2020/2021 plan year begins - Arcadia University
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2020 Employee Benefits Open Enrollment Guide Open Enrollment for the 2020/2021 plan year begins September 30, 2020 and ends on October 14, 2020.
INSIDE THIS GUIDE
Welcome Letter 3
Benefits Highlights and Enrollment Information 4
Benefits Eligibility 5
Summary of Benefit Plans 6
Medical Benefits: Personal Choice HDHP 8
Medical Benefits: Keystone Flex HMO 9
Prescription Drug Benefits 10
Vision Benefits: Personal Choice HDHP 11
Vision Benefits: HMO Plan 12
Voluntary Vision Benefits 13
Accident Injury Insurance 14
Hospital Care Insurance 15
Dental Benefits: Dental Care DHMO 16
Dental Benefits: Dental PPO 17
Flexible Spending Accounts 18
Life, AD&D and Disability Insurance 19
Pet Insurance - Additional Benefits 20
Employee Assistance Program 21
Wellness Resources 22
Additional Benefits: Retirement, Life Assistance, etc. 23
How to Enroll 25
Member Advocacy 26
Important Contact Information 27
2 | ARCADIA UNIVERSITY
Welcome to 2020
OPEN ENROLLMENT
Open Enrollment 2020-2021
Here at Arcadia University, we understand the importance of offering high quality and competitive health benefits to attract
and retain talented Faculty and Staff. The benefit plans we offer allow you the ability to choose a level of coverage that best
meets the needs for you and your family.
Our benefit plans include medical, prescription, vision, dental, life and disability insurance, retirement as well as various
other voluntary and intrinsic benefits that make up your total rewards package. It is important that you take time to review
this guide and any additional online resources to familiarize yourself with all of the terrific benefits available to you.
The following pages provide an overview of the core and intrinsic benefits offered by Arcadia and does not provide all plan
details. For additional resources, please refer to the summary plan documents on MyArcadia under the Human Resources
Benefit section or the online enrollment site used to complete your benefit plan enrollment.
This guide does not constitute or imply a contract of employment, nor does it guarantee the continuation of Arcadia
benefit programs. Arcadia reserves the right to amend or terminate any or all provisions of the benefits plan at any time.
When you are ready to make your benefit elections, go to www.plansource.com/login between September 30th and
October 14th and make your benefit elections. The benefit elections you select during this period will take effect on
November 1, 2020. You may only make changes to your benefits after open enrollment if you experience a qualified life
event for the next 14 months.
If you have any questions, please don’t hesitate to contact Human Resources at (215).572.4694.
All the Best,
Brian French
Director of Compensation and Benefits Administration
2020-21 OPEN ENROLLMENT | 3
BENEFIT HIGHLIGHTS &
ENROLLMENT INFORMATION
The Annual Open Enrollment period is
SEPTEMBER 30TH THROUGH OCTOBER 14TH, 2020.
Open Enrollment Highlights What’s new for 2020–21?
We are moving to a January 1st renewal date and Consolidating the HMO plans and offering
this plan year will run from November 1st, 2020 now one Keystone HMO plan.
through December 31st, 2021. We heard you! Now offering a new standalone
During this plan year we will be conducting a dependent Vision option through Vision Service Plan in addition
audit to verify the dependent status of everyone on to the core coverage included with the medical plan.
our plan. Please check your dependent's status to We are adding telemedicine through MDLive for
ensure you have the right dependents on the plan. the 2020/21 plan year, which can be accessed at no
cost to you!
Cigna will remain the carrier for Dental, Life
Insurance, Short Term Disability and Long
Term Disability.
Independence Blue Cross Medical Plans -
Reminder:
High Deductible and Keystone HMO plan ACTIVE ENROLLMENT
Employer Health Spending Account (HSA) Active enrollment means that all benefit
contributions to Personal Choice High Deductible
eligible employees of Arcadia MUST actively
Health Plan remain the same for 2020-21 plan year.
make benefit elections for Medical, Dental,
Employee only coverage receives $750 and Family
and Flexible Spending Accounts or will
coverage receives maximum of $1,500 annually.
default to “no coverage” for these benefits.
This account is funded per pay period and not
front loaded at the start of the benefit plan year. You must complete enrollment through
PlanSource (www.plansource.com/login)
no later than midnight Wednesday,
October 14th or you will not have
coverage effective November 1, 2020.
If you do not enroll by the end of the open
enrollment period, you will not be allowed to
enroll or change any benefit plans until next
year’s annual enrollment period unless you
experience a “qualified life event” during the
plan year.
4 | ARCADIA UNIVERSITY
BENEFIT ELIGIBILITY
Benefit eligibility is defined as: Choose your benefit plans and
You are eligible for coverage if you are an active, regular coverage levels carefully:
full time employee and work at least 1,500 hours per The IRS only allows changes to your benefit elections for
academic year. certain qualifying status changes:
Loss of coverage or acquisition of new coverage
Eligible dependents include: from another source
Your spouse.
Change in Employee’s legal marital status
Your married or unmarried children until the end (marriage or divorce)
of the month of their 26th birthday. Such children
Change in number of eligible dependents
include (a) a blood descendant of the first degree,
(i.e. birth, death, court order)
(b) a legally adopted child (including a child living
with the adopting parents during the period of Dependent now satisfies or ceases to satisfy
probation), (c) a child for whom you have legal dependent eligibility requirements
guardianship, (d) a stepchild or (e) a child who is Change in employment status that affects benefit
the subject of a Court Order. eligibility
Your married or unmarried children covered prior Legal Judgments, Decrees or Orders
to attainment of age 26 and who are incapable of
Significant changes in coverage under the plan
employment by reason of mental retardation or
of the spouse’s or dependent’s employer
physical handicap and who became incapable prior
to age 26, Newborn children for thirty-one (31) Separation from service
days after birth, a Domestic Partner, Married or
Unmarried Children of a Domestic Partner.
As a reminder, we will be auditing all dependent records this year
to ensure dependents are eligible for the plan as described here.
Please contact Human Resources with Qualifying Life Events
any questions regarding eligibility. If you experience a qualifying status change
and want to make a change to your benefits,
please contact Human Resources within
30 days of the event. Documentation will be
required to substantiate the Qualifying Life
Event and the transaction should be done
using the online benefit enrollment site.
2020-21 OPEN ENROLLMENT | 5
SUMMARY OF BENEFIT PLANS
Arcadia University provides colleagues with a choice of competitive medical benefit options to meet an array of
individual and family needs for health promotion, preventive care and when necessary, major medical expenses.
Arcadia offers two Independence Blue Cross options: the Personal Choice High Deductible Health Plan (HDHP)
and Keystone HMO plan. Both plans include a formulary prescription drug plan. Note: The Keystone HMO plan is
available only to employees who live in the five-county area (Philadelphia, Montgomery, Bucks, Berks, Delaware,
and a small portion of Southern New Jersey). However, there are some counties that border these five counties that
may allow use of the Keystone HMO plan. Please contact HR to inquire.
Personal Choice HDHP NEW! Keystone HMO Plan
A high deductible PPO plan. After the deductible is met, A Keystone HMO plan with a $20 or $40 co-pay for office
there is 100% coverage on all in-network medical expenses, visits and a $15/$50/$75 co-pay for prescription drugs.
with the exception of prescription coverage, which carries a
This plan has co-pays for some services, such as physical
co-payment of $5/$20/$45. Out-of-network coverage is
therapy and diagnostic tests. For hospitalization and
subject to a $5,000/$10,000 deductible and 50%
out-patient surgery, the plan pays 90% after deductible.
coinsurance. When enrolled in a High Deductible PPO
See page 9 for more benefit details.
plan, employees can open a Health Savings Account
referred to as HSA. An HSA account permits employees
to set aside pre-tax dollars to pay for medical expenses until
the deductible is met. Employees enrolled in Medicare or
have other health insurance are not permitted to contribute
to an HSA. An HSA is a tax-advantaged health care account
that you own. You contribute to it with tax-free or tax-
deductible funds. You can use those funds to pay for
eligible health care expenses now and in the future.
This includes expenses for you, your spouse and your
tax dependents. This is true even if your spouse and
dependents are not on your health plan. To contribute
to an HSA you must be enrolled in the High
Deductible Health Plan (HDHP).
The IRS maximum limit on contributions for
this coming plan year are $3,600 self only and
$7,200 Family. Additionally, Arcadia contributes annual
amounts of $750 towards Single coverage and $1,500
towards family coverage to help you meet the required
deductible amounts. The funds that you contribute but
don’t use will roll over year to year. In addition, an
HSA is portable which means that if you change employers
or leave the workforce, the HSA stays with you.
6 | ARCADIA UNIVERSITY
SUMMARY OF BENEFIT PLANS
Flexible Spending Accounts (FSA)
Flexible Spending Accounts enable employees to set aside
pre-tax income to pay for eligible child/dependent care costs
and/or out-of-pocket medical costs. This is accomplished
through pay reductions, which lower your federal taxable
income. Money set aside in the FSA is not subject to federal
income taxes or FICA taxes, and is used to reimburse the
employee for actual dependent and health care costs paid.
In addition, funds that are set aside for Health Care FSAs
are also exempt from PA state taxes. If you enroll in the
High Deductible Health Plan, you cannot enroll in a
healthcare FSA plan, but you will have a health savings
account available.
There are two types of Flexible Spending Accounts:
Dependent Care Spending Accounts and Health Care
(including dental and vision) Spending Accounts.
Cigna DHMO or Cigna PPO Employees may set up one or both accounts. Establishing
Dental insurance is currently provided by Cigna. a FSA is generally limited to the beginning of employment
Note: The Cigna DHMO plan is available only to and the open enrollment period.
employees who live in the five-county area
(Philadelphia, Montgomery, Bucks, Berks, Delaware, Debit cards are available for both the Health Care and
and a small portion of Southern New Jersey). Dependent Care FSA. Use of the debit cards enables
direct payment for eligible out-of-pocket medical
Search for a Dentist expenses or costs at participating dependent care
Once you enroll in Cigna DHMO, register at facilities and eliminates the need to submit claim forms
myCigna.com. You can search for a dentist using your and wait for reimbursement. Dependent care expenses
home zip code. You can search for a network dentist by are limited to the current account balance each month.
name, specialty or location. Just follow these easy steps:
See additional details regarding these plans and
Log in to myCigna.com.
covered services on the following pages.
Click on “Find a Doctor, Dentist or Facility.”
Under “Find a…” click “Dentist.”
This information is also available on the myCigna
mobile app. Call Cigna at 800.Cigna24 to speak
directly to a customer service representative.
2020-21 OPEN ENROLLMENT | 7
MEDICAL BENEFITS
Independence Blue Cross
Personal Choice High Deductible Health Plan (HDHP)
BENEFIT DESCRIPTION IN-NETWORK OUT-OF-NETWORK
Deductible (Individual/Family) $1,500/$3,000 $5,000/$10,000
Out-of-Pocket Maximum (Individual/Family) $6,350/$12,700 $10,000/$20,000
Preventive Care Services No charge, no deductible 50%, no deductible
Referral Not required
Primary Care Physician Office Visit No charge, after deductible 50%, after deductible
Specialist Office Visit No charge, after deductible 50% , after deductible
Diagnostic Laboratory No charge, after deductible 50%, after deductible
Diagnostic X-Ray/Imaging (MRI, CT-Scan) No charge, after deductible 50%, after deductible
Emergency Room No charge, after deductible Covered at in network level
Urgent Care Center No charge, after deductible 50%, after deductible
Inpatient Hospital No charge, after deductible 50%, after deductible
Outpatient Surgery No charge, after deductible 50%, after deductible
This is only a summary of coverage. Please login to PlanSource to see the full benefit details.
Health Savings Account (HSA) Monthly Employee Contributions
This plan includes a Health Savings Account that TIER YOU PAY
Arcadia contributes towards. Arcadia University will
Employee Only $81.00
help you meet the required deductible amounts by
contributing “up to” the following annual amounts: Employee & Child(ren) $429.00
$750 single/$1,500 other tier levels. Employees are also
Employee & Spouse $441.00
eligible and encouraged to contribute on a pre-tax basis.
If you enroll in the HSA Plan, you cannot enroll in the Family $441.00
Healthcare Flexible Spending Account through PayFlex.
Note: To determine your cost per paycheck, multiply the above amounts
Note: If you are enrolled in Medicare part A or B, times 12 and divide by 24 if paid semi-monthly or 26 if paid bi-weekly.
you may not contribute to a Health Savings If you opt out of both the medical and dental plans you are eligible
Account according to IRS regulations. for a $100 per month opt out credit.
8 | ARCADIA UNIVERSITY
MEDICAL BENEFITS
Independence Blue Cross
NEW! Keystone HMO Plan
BENEFIT DESCRIPTION IN-NETWORK, YOU PAY:
Deductible (Individual/Family) $250/$500
Out-of-Pocket Maximum (Individual/Family) $6,350/$12,700
Preventive Care Services No Charge
Referral Required
PCP Office Visit $20
Specialist Office Visit $40
Diagnostic Laboratory No Charge
Diagnostic X-Ray/Imaging $40
MRI, CT-Scan $80
Emergency Room $150 (waived if admitted)
Urgent Care Center $105
Inpatient Hospital 10% after deductible
Outpatient Surgery 10% after deductible
This is only a summary of coverage. Please login to PlanSource to see the full benefit details.
In-Network Only Monthly Employee Contributions
The HMO plan is an In-Network only TIER YOU PAY
plan. Members will pay full cost for out-
Employee Only $46.50
of-network services. These plans are only
available to employees who live in the five Employee & Child(ren) $176.50
county area (Philadelphia, Montgomery,
Employee & Spouse $376.00
Bucks, Berks, and Delaware). Most
services are not covered if performed Family $547.00
out-of-network.
Note: To determine your cost per paycheck, multiply the above amounts times 12 and
divide by 24 if paid semi-monthly or 26 if paid bi-weekly.
If you opt out of both the medical and dental plans you are eligible for a $100 per
month opt out credit.
2020-21 OPEN ENROLLMENT | 9
PRESCRIPTION DRUG BENEFITS
Independence Blue Cross
NOTE: If you enroll in one of the medical plans, you are automatically enrolled in the
prescription drug benefit.
Retail (30-day supply) Mail Order (90-day supply)
HDHP KEYSTONE HMO PLAN HDHP KEYSTONE HMO PLAN
Generic $5 copay* $15 copay $10 copay* $30 copay
Formulary $20 copay* $50 copay $40 copay* $100 copay
Non-Formulary $45 copay* $75 copay $90 copay* $150 copay
* Members in the HDHP pay full cost for drugs until deductible is met.
New for 2020-21 How much can you save when you use Mail Order?
Briova Specialty Pharmacy will be our new Compare for yourself…
exclusive provider of specialty drugs. RETAIL PHARMACY MAIL ORDER ANNUAL
Up to a 30-day supply Up to a 90-day supply SAVINGS
Save on your Prescriptions Formulary Copay Formulary Copay
with Mail Order! $50 $100
Using the mail order program for your
maintenance medications will save you money.
Annual cost
($35 per month x 12
Annual cost
($70 per order
$200
fills) x 4 fills per year)
You will receive up to a 90-day (3-month)
$600 $400
supply for two retail copays. In addition to
the savings, your prescriptions will be
delivered right to your home.
NOTE: To begin using mail order through
Future Scripts, simply complete a mail
order form at www.ibx.com and send
along with your prescription(s) written
for a 90-day supply of medication. The form
is located under Individual/Member
Services section of the portal.
10 | ARCADIA UNIVERSITYVISION BENEFIT (PERSONAL CHOICE HDHP)
Independence Blue Cross
Vision benefits are a rider on all of the medical plans. Arcadia’s benefit program offers a network of vision care
providers through Independence Blue Cross (IBX) administered by Davis Vision. The chart below is a summary of
the benefits available to you. To locate a Davis Vision Network provider, go to www.ibx.com and click on the
“Find a Doctor” feature.
$75 Vision Program
BENEFIT DESCRIPTION IN-NETWORK IN-NETWORK
Exam $0 Up to $35 reimbursement*
Choose from participating providers own frame collection and receive $60(2) or choose from
Davis Collection or frames that are available at most participating providers and pay:
Frames Fashion selection $0
Designer selection $0
Premier Selection $20
Lenses
Single Vision Lenses
Spectacle lenses covered at no extra cost include: all range of prescriptions, oversized lenses,
Bifocal Lenses
glass or plastic lenses, single visions, bifocal, trifocal or lenticular lenses
Trifocal Lenses
Lenticular Lenses
Eyeglasses
Including spectacle lenses and frames, Eyeglasses (spectacle lenses and frames) are available up to a $75 reimbursement
at non-participating providers
Contact Lenses
Allowance up to $75** Up to $75 reimbursement*
(in lieu of eyeglasses)
Frequency
Vision Exam
Once every two calendar year
Lenses
Frames
* in lieu of participating provider benefit, member
** Member is responsible for balance
2020-21 OPEN ENROLLMENT | 11VISION BENEFIT (KEYSTONE HMO PLAN)
Independence Blue Cross
Vision benefits are a rider on all of the medical plans. Arcadia’s benefit program offers a network of vision care
providers through Independence Blue Cross (IBX) administered by Davis Vision. The chart below is a summary of
the benefits available to you. To locate a Davis Vision Network provider, go to www.ibx.com and click on the
“Find a Doctor” feature.
$100 Eyewear Benefit Biennial Benefit
BENEFIT DESCRIPTION IN-NETWORK IN-NETWORK
Eyeglasses (including spectacle lenses and frames,
at participating providers)
Spectacle lenses Spectacle lenses covered at no extra cost include all range of prescription, oversize lenses,
Additional lens option glass or plastic lenses, single vision, bifocal, trifocal or lenticular lenses.
Frames
Two options are available for selecting frames
Additional spectacle lens options covered at not cost include: glass grey #3 prescriptions
Additional Lens options sunglasses, tinting, polycarbonate lenses for dependent children, monocular patient, and
patients with prescriptions greater than or equal to +/-6.00 diopters.
Eyeglasses including spectacle lenses Eyeglasses (spectacle lenses and frames) are available
and frames at non-participating providers up to a $100 reimbursement
Contact lenses (in lieu of glasses) including
standard, specialty and disposable lenses and Allowance up to $100* Up to $100 reimbursement**
evaluation and fitting
Please refer to your medical coverage benefits for information about out-of-pocket maximum values.
Out-of-Pocket maximum includes applicable copayments, coinsurance and deductibles.
Total Out-of-Pocket Maximum
Your out-of-pocket maximum is a combined maximum of medical, prescription drug and any
included pediatric vision and pediatric dental benefits as defined by your benefit plan.
Frequency Once every two calendar years
* in lieu of participating provider benefit, member
** Member is responsible for balance
12 | ARCADIA UNIVERSITY
12 | ARCADIA UNIVERSITYVOLUNTARY VISION BENEFITS
Vision Service Plan
PLEASE NOTE: Starting November 1, 2020, eligible employees have the option of electing the Vision Service Plan
in addition to the core coverage included with Medical.
NEW! Vision Service Plan
IN-NETWORK OUT-OF-NETWORK
Exam $10 Copay Reimbursed up to $45
Covered up to $130
Frames Reimbursed up to $70
(20% off amount over allowance)
Lenses
Single Vision Lenses Reimbursed up to $30
Bifocal Lenses Covered in full after $10 copay Reimbursed up to $50
Trifocal Lenses Reimbursed up to $65
Lenticular Lenses Reimbursed up to $100
Contact Lenses
Covered up to $130 Reimbursed up to $105
(in lieu of eyeglasses)
Frequency
Vision Exam
Once every 12 months Once every 12 months
Lenses
Frames
VSP Online Resources Monthly Employee Contributions
Be sure to register online at www.vsp.com to find TIER YOU PAY
a provider, check your claim status, print your
Employee Only $9.17
member ID card, and review your benefit details.
Employee & Child(ren) $14.98
Employee & Spouse $14.67
Family $24.15
Note: To determine your cost per paycheck, multiply the above amounts
times 12 and divide by 24 if paid semi-monthly or 26 if paid bi-weekly.
2020-21 OPEN ENROLLMENT | 13ACCIDENTAL INJURY INSURANCE
Cigna
Accidental Injury coverage provides a benefit according to the schedule below when a Covered Person suffers
Covered Injuries or undergoes a broad range of medical treatments or care resulting from a Covered Accident.
This coverage is separate from any medical coverage you may have. You are sent a check if you or family
members experience a covered accidental injury.
Who can elect coverage? Monthly Employee Contributions
Employee: All active, Full-time Employees of the TIER PLAN 1 PLAN 2
Employer who are United States citizens or permanent
Employee Only $9.96 $18.29
resident aliens regularly working a minimum of
30 hours per week in the United States. You will be Employee & Child(ren) $18.47 $33.58
eligible for coverage the first of the month coincident
Employee & Spouse $17.50 $32.02
with or following date of hire.
Spouse: Up to age 70, as long as you apply for and Family $25.27 $45.85
are approved for coverage yourself.
Note: To determine your cost per paycheck, multiply the above amounts
Child(ren): Birth to 26, as long as you apply for times 12 and divide by 24 if paid semi-monthly or 26 if paid bi-weekly.
and are approved for coverage yourself.
Accidental Injury Insurance
INITIAL & EMERGENCY PLAN 1 PLAN 2
Ground Ambulance $300 $400
Air Ambulance $1,200 $1,600
Emergency Care Treatment $100 $200
Diagnostic Exam (X-ray or lab) $10 $50
Physician Office Visit $50 $100
HOSPITALIZATION BENEFITS PLAN 1 PLAN 2
Hospital Admission $500 $1,000
Hospital Stay (per day) $100 $200
Intensive Care Unit (per day) $200 $400
WELLNESS, HEALTH SCREENING TEST, OR PREVENTIVE CARE BENEFIT PLAN 1 PLAN 2
Examples include (but are not limited to) routine gynecological
exams, general health exams, mammography, and certain blood tests. $50 per day $75 per day
A 30-day benefit waiting period applies during which benefits will not be paid.
14 | ARCADIA UNIVERSITYHOSPITAL CARE INSURANCE
Cigna
Hospital Care coverage provides a benefit according to the schedule below when a Covered Person incurs a
Hospital stay resulting from a Covered Injury or Covered Illness. You are sent a check if you or family members
experience a covered accidental injury.
Who can elect coverage? Monthly Employee Contributions
Employee: All active, Full-time Employees of the TIER PLAN 1
Employer who are United States citizens or permanent
Employee Only $21.09
resident aliens regularly working a minimum of
30 hours per week in the United States. You will be Employee & Child(ren) $34.62
eligible for coverage the first of the month coincident
Employee & Spouse $40.92
with or following date of hire.
Spouse: Up to age 70, as long as you apply for and Family $54.46
are approved for coverage yourself.
Note: To determine your cost per paycheck, multiply the above amounts
Child(ren): Birth to 26, as long as you apply for times 12 and divide by 24 if paid semi-monthly or 26 if paid bi-weekly.
and are approved for coverage yourself.
Hospital Care Insurance
HOSPITALIZATION BENEFITS PLAN 1
Hospital Admission
No Elimination Period. $1,000 per day
Limited to 1 day, 1 benefit(s) every 90 days.
Hospital Chronic Condition Admission
No Elimination Period. $50 per day
Limited to 1 day, 1 benefit(s) every 90 days.
Hospital Stay
No Elimination Period. $100 per day
Limited to 30 days, 1 benefit(s) every 90 days.
Hospital Intensive Care Unit (ICU) Stay
No Elimination Period. $200 per day
Limited to 30 days, 1 benefit(s) every 90 days.
Hospital Observation Stay $100 per
1 hour Elimination Period. Limited to 72 hours. 24-hour period
2020-21 OPEN ENROLLMENT | 15DENTAL BENEFITS (DENTAL CARE DHMO)
Cigna
Arcadia University offers you a choice of two Cigna dental plans: Dental HMO and Dental PPO (page 17).
The Dental HMO (DHMO) plan helps to streamline your dental care and makes most preventive and diagnostic
services available at a reasonable cost or no additional cost to you, including yearly fluoride treatments for covered
children. There is a copay for covered services, but no deductibles or annual dollar maximums, no coverage
waiting periods and no claim forms to complete. Be sure to choose a primary dental provider for care; you
may change dental providers anytime by calling 1.800.Cigna.24.
Cigna Dental Care –DHMO
WHAT YOU’LL PAY
COST WITH CIGNA ESTIMATED COST WITHOUT
SAMPLE OF COVERED PROCEDURES
DENTAL CARE DENTAL COVERAGE
Adult Cleaning (two per calendar year each at $0)
$0 $70 – $136 each
(additional cleanings available at $41 each)
Child cleaning (two per calendar year each at $0)
$0 $53 – $102 each
(additional cleanings available at $30 each)
Periodic oral evaluation $0 $40 – $76
Comprehensive oral evaluation $0 $62 – $118
Topical fluoride (two per calendar year each at $0.
$0 $28 – $53
(additional topical fluoride available at $15 each)
X-rays: (bitewings) 2 films $0 $33 – $63
X-rays: panoramic film $0 $84 – $161
Sealant: per tooth $10 $42 – $80
Amalgam filling (silver-colored): 2 surfaces $10 $118 – $226
Composite filling (tooth-colored): 1 surface, Anterior $15 $120 – $231
Molar root canal (excluding final restoration) $280 $852 – $1,640
Comprehensive orthodontics-child (up to 19th birthday): Banding $400 $1,042 – $2,005
Periodontal (gum) scaling & root-planning: 1 quadrant $55 $179 – $344
Periodontal (gum) maintenance $35 $109 – $209
Removal/extraction of erupted tooth $10 $120 – $231
Removal/extraction of impacted tooth $115 $370 – $712
Crown: porcelain fused to high noble metal $255 $849 – $1,634
Implant supported retainer for porcelain fused to metal fixed partial denture $555 $1,097 – $2,112
Occlusal appliance, by report (for treatment of TMJ) $216 $640 – $1,233
Monthly Employee Contributions
TIER YOU PAY
Employee Only $4.00
Employee & Child(ren) $6.00
Employee & Spouse $7.00
Family $8.00
Note: To determine your cost per paycheck, multiply the above amounts
times 12 and divide by 24 if paid semi-monthly or 26 if paid bi-weekly.
16 | ARCADIA UNIVERSITYDENTAL BENEFITS (DENTAL CARE PPO)
Cigna
With the Cigna Dental PPO (DPPO) plan you can visit any dentist in- or out-of-network and you never need a referral to
see a specialist. You also have access to most preventive services at a reasonable cost or at no additional cost to you.
If you would like a copy of your ID card please visit www.cigna.com and login to download a copy.
Cigna Dental PPO
IN-NETWORK OUT-OF-NETWORK
Calendar Year Deductible (Individual/Family) $0/$0 $0/$0
Calendar Year Maximum (per patient) $1,500; Preventive Services apply $1,500; Preventive Services apply
Preventive & Diagnostic Services
Exams, Cleanings, Routine X-rays (each twice in a calendar year)
Fluoride Application (once in a calendar year, children to age 19)
Sealants (under age 14) 100%, No Deductible 100%, No Deductible
Space Maintainer (limited to non Orthodontic treatment)
Non-Routine X-rays
Emergency Care to Relieve Pain
Basic Services
Fillings (Amalgam and composite on all teeth)
Oral Surgery – Simple Extractions
Oral Surgery – All Except Simple Extraction
Surgical Extractions of Impacted Teeth
100%, No Deductible 100%, No Deductible
Anesthetics
Root Can Therapy/Endodontics
Brush Biopsy
Repairs – Dentures
Stainless Steel/Resin Crowns
Major Services
Major/Minor Periodontics
Crowns/Inlays/Onlays
Dentures 80%, No Deductible 80%, No Deductible
Bridges
Relines, Rebases, and Adjustments
Repairs – Bridges, Crowns, and Inlays
Orthodontia
Coverage for Eligible Children Only 50%, No Ortho Deductible 50%, No Ortho Deductible
Lifetime Maximum $1,500 $1,500
Monthly Employee Contributions
TIER YOU PAY
Employee Only $10.00
All Other Tiers $68.00
Note: To determine your cost per paycheck, multiply the above amounts
times 12 and divide by 24 if paid semi-monthly or 26 if paid bi-weekly.
2020-21 OPEN ENROLLMENT | 17FLEXIBLE SPENDING ACCOUNTS (FSA)
PayFlex
A Flexible Spending Account (FSA) allows you to set aside money for eligible expenses on a pre-tax basis.
See the example below how this account can save you cash! You can carry over $500 from your medical FSA
into the following year. Examples of eligible FSA expenses include doctor office visit copays, prescription drug
copays or vision care, For a complete list, visit www.irs.gov/publications/p502.
Health Care Flexible Spending Example of how FSA
Account (FSA) Contributions can increase your
The minimum annual election is $130 and the maximum spendable income!
election is $2,750. PayFlex will issue a debit card with Bob and Jane’s combined gross income is $30,000.
your elected amount to use on eligible expenses during They have two children and file their income taxes jointly.
the year. Up to $500 of unused FSA dollars will be carried Since Bob and Jane expect to spend $2,000 in adult
over into the next plan year. You will not receive a new orthodontia and $3,300 for day care next plan year,
debit card until you reach the expiration date on your they decide to direct a total of $5,300 into their FSAs.
current card.
WITHOUT FSAS WITH FSAS
Dependent Care Flexible Spending
Gross income: $30,000 $30,000
Account (FSA)
FSA contributions: $0 -$5,300
The minimum annual election is $130 and the maximum
Gross income: $30,000 $24,700
election is $5,000. You can reimburse yourself on daycare
Estimated Taxes:
expenses paid during the year by submitting a claim form
or using your debit card. You can receive up to the Federal -$2,550* -$1,755*
amount contributed into the dependent care FSA at State -$900** -$741**
anytime during the year. Unused dependent care FSA FICA -$2,295 -$1,890
dollars are forfeited and cannot be rolled over into the After-tax earnings: $24,255 $20,314
next plan year. Eligible Out-of-Pocket:
Medical and dependent
-$5,300 $0
care expenses:
Enrollment Reminder! Remaining spendable
$18,955 $20,314
income:
You MUST enroll each benefit plan year if
Spendable
$1,359
you wish to continue with the pre-tax savings income increase:
of the medical and/or dependent care Flexible * Assumes standard deductions and four exemptions.
Spending Accounts. ** Varies, assume 3%.
The example above is for illustrative purposes only. Every situation
varies and we recommend that you consult a tax advisor for all
tax advice.
18 | ARCADIA UNIVERSITYLIFE, AD&D AND DISABILITY INSURANCE
Cigna
Basic Life and AD&D Insurance
All active, full-time employees regularly working at least
35 hours each week are automatically enrolled in the Basic
Life and Accidental Death and Dismemberment (AD&D)
plan. This coverage is available to Arcadia employees at
no cost - the university pays 100% of the Basic Life and
AD&D premium. The Basic Life and AD&D benefit is 1.5
times annual earnings to a maximum amount of $500,000.
Supplemental Voluntary Life
and AD&D
All full-time employees who work a minimum of 1,500
hours per academic year may purchase supplemental life
insurance for themselves in an amount of up to 5 times base
salary in increments of $10,000 (not to exceed $500,000).
Coverage may also be purchased for spouses or qualified
domestic partners in increments of $5,000 up to an amount
Short-Term Disability
of 100% of the employee’s supplemental insurance. Short-term disability support shall be available to full time
Dependent children (up to age 26) may be covered in employees of Arcadia University after one year of
increments of $2,000 up to a maximum of $10,000. The continuous full time employment. Short-term disability
maximum benefit for a child between the ages of live birth benefits may continue for up to six months with proper
and 6 months is $1,000. medical documentation.
Coverage for all or part of your supplemental insurance Long-Term Disability
may be subject to evidence of insurability (EOI). Any
After one year of continuous full-time employment,
increase amount during open enrollment will require an
the University pays the premium for a disability group
EOI. Coverage will reduce to 65% of the original amount
insurance plan. Under this disability program, after six
at age 70, and to 50% of the original amount at age 75.
months of total disability, eligible employees may apply
Other limitations and exclusions may apply. Additional
for long-term disability benefits. If approved by the
information is available through Cigna or in the Human
insurance company, employees will receive 60% of their
Resources/Benefits area @ My Arcadia.
base salary up to the plan maximum. Waiting period for
enrollment may be waived if you can provide proof that
you were covered under a similar group employer plan
within the last 90 days.
2020-21 OPEN ENROLLMENT | 19ADDITIONAL BENEFITS: PET INSURANCE
Figo
What is Pet Insurance? Pre-Existing Conditions
A health insurance plan that covers the illnesses and injuries All pet insurance companies exclude pre-existing
of your pet. This includes veterinarians, ERs, and specialists. conditions.
How It Works Deductibles
If your pet is sick or injured, you can receive treatment All Figo plans are based on annual deductibles,
from any licensed veterinarian in the US, Puerto Rico, not per condition.
or Canada.
10 Great Figo Advantages
What It Covers Low, easy annual deductible
All illnesses and injuries, including hereditary and Exam fee paid for covered illnesses and injuries
congenital, are covered as long as they were not Copay & deductible waived for emergency,
pre-existing conditions. life-saving treatments
Vet Exams Vet Specialists Unlimited lifetime benefit with 100%
Hospitalization Hereditary Conditions reimbursement plan
Alternative and holistic treatments fully covered
Surgeries Congenital Conditions
Claims paid on vet bill, regardless of treatment
Prescriptions Hip Dysplasia
type or cost
Cancer Treatments And more!
Curable pre-existing conditions covered if free
CAT Scan, MRIs, X-Ray
for 12 months
No upper age limits. Period.
Waiting Periods
Generous lost pet protection
Figo’s waiting periods are: 5 days for injuries, Same low deductible and copay for specialists
14 days for illnesses, and 6 months for knees. and emergency rooms
All waiting periods can be waived by vet exams.
Plan Options
ESSENTIAL PREFERRED ULTIMATE
Annual Vet Fees $10,000 $14,000 Unlimited
Emergency Boarding
Advertising & Reward
Lost Pet
Vacation Cancellation
Mortality Benefit
20 | ARCADIA UNIVERSITYEMPLOYEE ASSISTANCE PROGRAM
Carebridge
What is an Employee Assistance
Program (EAP)?
EAP is a service provided to you when you are having
difficulty resolving life concerns on your own. The EAP
can provide immediate consultation to assist you in
reducing the distress associated with many of the challenges
you may be encountering. Callers often feel more
empowered to move forward with managing their concern
after one consultation. In other situations, you may want to
take advantage of an allotted number of in-person or
telephonic appointments with professional clinicians to
Is there a fee for using
address concerns such as: daily stress, relationship conflicts,
alcohol and drug abuse, eating disorders, unhealthy
Carebridge’s services?
lifestyles, parenting problems, depression or anxiety, Your employer has contracted for the professional
grief and loss, and relationship abuse. services of Carebridge Corporation. These services are
made available to you cost-free. The decision and
How can I research my EAP or Work financial responsibility for any service beyond the scope
Life concern on my own? of the benefits described rests solely with the user.
MyLifeResource.com is a comprehensive, interactive
website providing expert articles and resources on the
topics that matter most to you. Helpful tools include: Contacting Carebridge
streamed videos, self-assessments, interactive wellness
No matter where you are, Carebridge is
tutorial, online trainings, databases to assist with child
available to help. Use any of the following
care, eldercare, relocation, education, an employee
discount center, legal documents, financial calculators, options to contact Carebridge:
polls and tips. At any time, you can also call Carebridge Call Carebridge toll-free 800.437.0911
to consult directly with an EAP Clinician or Work-Life for immediate consultation
Specialist to further your search.
Visit www.myliferesource.com to find
How confidential is the EAP? expert articles, resources and unique tools
addressing a large scope of EAP and
Carebridge EAP services are confidential. No names are
identified or reported to anyone without your written Work-Life issues.
authorization except in the following situations; by court Or download the Carebridge Mobile App
order, imminent threat of harm to self or others, or from the App Store or Google Play
situation of abuse (such as child or elder abuse).
Your Access Code is 6CSKH.
2020-21 OPEN ENROLLMENT | 21WELLNESS RESOURCES
These resources are available—at no cost—to all HealthyLearn
employees who are enrolled in any of the IBC HealthyLearn is a portal that includes the best, most
(Independence Blue Cross) medical plans. interactive and source-based data on wellness and medical
topics available. For more information, visit Healthy Learn
Personal Health Profile today at: www.healthylearn.com/connerstrong
This is an online health assessment that provides a snap shot
of your health and personalizes an action plan to help you GoodRx
get healthy. Good Rx allows you to simply and easily search for
retail pharmacies that offer the lowest price for specific
Tobacco Cessation medications. Use Good Rx to compare drug prices at
Receive money back when you complete an approved local and mail-order pharmacies and discover free
program to help you quit smoking. coupons and savings tips. Find out how GoodRx
can save on your prescription drugs by visiting
Blue365 www.connerstrong.goodrx.com
Save on health-related products and services with exclusive
value-added discounts and offers from leading national
companies.
GlobalFit Gym Discount Program
GlobalFit offers discounts at more than 10,000 gyms
nationwide. Members also get exclusive savings on home
health and fitness products including Zumba, Total Gym,
Schwinn, StairMaster and more! Learn more about
GlobalFit by calling 800.294.1500 or visit
www.globalfit.com/connerstrong
22 | ARCADIA UNIVERSITYADDITIONAL BENEFITS
Retirement Tuition Remission
Take advantage of the Arcadia University 403(b) matching All full time employees are eligible for tuition remission at
plan and build your retirement. When you set aside up to Arcadia for undergraduate, graduate and doctoral study.
6% of your annual salary to the plan on a tax deferred basis, Employees are limited to two courses each semester for
Arcadia University will provide a matching contribution up tuition remission. Tuition remission covers 100% tuition
to 6% - a total contribution rate of 12%. And, if you set but does not include any fees, housing and other expenses.
aside 6.5% or more of your annual salary to the plan on a All state and federal grants and scholarships, including
tax deferred basis, Arcadia will provide an 8% match, Arcadia scholarships, will be deducted from the tuition
bringing your contribution total up to 14.5%. In addition charges before tuition remission benefits are applied.
to a tax deferred option, we also offer a Roth post tax
investment option. For any clarification, more details or any questions, visit
myarcadia.com or contact Human Resources at
While you are encouraged to speak with your own Financial 215.572.2813.
Advisor, you have access to a Financial Consultant at TIAA.
To request an appointment for a one on one advice session Cigna Additional Resources
call 800.732.8353. We have a dedicated TIAA Financial
Cigna Secure Travel
Consultant that comes to campus regularly throughout the
year so stay tuned for more information in the HR Cigna Secure Travel provides special assistance for
newsletter and periodic emails. These sessions fill up fast emergency medical, financial, legal and communication
so don’t delay! assistance when you travel. This program gives covered
individuals access to a travel assistance customer service
To begin investing more for your future, call center from anywhere in the world when traveling at least
800.842.2252 Monday through Friday 8am to 10pm 100 miles from home. For more information about Secure
and Saturday from 9am to 6pm. The TIAA consultants Travel, call 888.226.4567.
will answer your questions and take you step by step
through your plan choices and suggest a portfolio Will Preparation
allocation tailored to your preferences and long term Cigna’s Will Preparation Program helps you and your
savings goals. You may also access your account online at family to plan and protect your financial future by using a
www.tiaa.org/public/tcm/arcadia/home. Ideally, you simple online tool. The tool allows you to build state
should be reviewing your portfolio at least twice per year. specific customized wills and other legal documents such as
last wills, living wills, and power of attorneys. Cigna’s Will
Center is secure, easy to use and available to you and your
covered spouse seven days a week, 365 days a year. Visit
cigna.mysecureadvantage.com to register and learn more.
2020-21 OPEN ENROLLMENT | 23ADDITIONAL BENEFITS
Paid Time Off (PTO) Holidays
Arcadia University offers a generous PTO allotment to The following holidays will be observed:
all regular full-time 12 month employees. Part time New Year's Day, Memorial Day, Independence Day,
staff members who are expected to work at least 1000 Labor Day, Thanksgiving Day, Day after Thanksgiving,
hours per year will earn prorated vacation. See PTO Christmas Eve Day and Christmas Day.
policy for further details.
Most university offices are closed during the week between
Vacation Christmas Day and New Year's Day. Some offices cannot
Vacation pay is earned according to classification and length close completely because of the nature of their operation.
of employment. Vacation will be accrued each payroll cycle The supervisor can explain which employees would be
at the appropriate rate, and balances will be reflected in required/asked to work during that time.
total hours.
Bereavement Leave
Personal
In the event of a death in the employee’s immediate family,
All regular, full-time staff members are given two personal the University may grant leave with pay not to exceed three
days each year. Personal time for those who have been days. Immediate family is defined as spouse, domestic
employed by the University for less than one complete
partner, brother, sister, child, daughter-in-law, son-in-law,
fiscal year is pro-rated.
stepchild, grandchild, parent, mother-in-law, father-in-law,
Sick and grandparent. One day off with pay may be granted by
the University in the event of a death of an aunt, uncle,
All regular, full-time, non-faculty employees receive sick
brother-in-law, sister-in-law, nephew or niece.
time. Employees will receive their full allotment, which is
the equivalent of the yearly cap, of sick time on June 1st of
each fiscal year. Sick time is not carried over into the new
fiscal year. 9, 10 and 11 month employees receive a
prorated amount. Employees are eligible to use sick time
for personal illness or illness in the immediate family
(spouse, children, and parent).
24 | ARCADIA UNIVERSITYHOW TO ENROLL
To enroll in benefits, go to www.plansource.com/login.
Step 1: When you arrive on the landing page please enter your Username and Password
Username: Your username is the first initial of your first name, up to the first six letters of your last name,
and the last four digits of your SSN.
For example, if your name is Taylor Williams, and the last four digits of your SSN are 1234, your
username would be twillia1234.
Password: Your initial password is your birthday in the YYYYMMDD format.
So, if your birthdate is June 4, 1979, your password would be 19790604. The first time you log in,
you will be prompted to change your password.
Step 2: Once logged in, click “Get Started” on the Homepage to begin.
Step 3: First, you will be asked to review and update your profile and ensure that all information listed about yourself
and your family members is correct.
Step 4: Now you can begin shopping for benefits. Educational material about the specific plan type is available at the
top of the page.
Filter. If your company offers three or more plans, you will be able to filter available plans based on a
variety of criteria.
Plan Overview. Plan choices are displayed on “cards,” which provide a brief summary of what is included in
the plan. Click a card to get more detail.
Plan Details. The plan detail page will give you information about each plan, including deductible, cost
per pay period and projected costs.
Select Plan. To select a plan, indicate which family members are covered by clicking “edit family covered”
and select the card for each family member you would like to be on the plan. Click “Update Cart”
to choose the plan.
Shopping Cart. The shopping cart displays a
running total of your combined benefits costs
and shows progress. You will need to select or
decline a plan in each benefit type before you
can check out. If you elected Life Insurance be
sure to use the “ADD Beneficiaries” button to
add your beneficiaries.
Step 5: To finalize your choices, click “Review and
Checkout.” You must complete the checkout
process in order to be enrolled in benefits.
2020-21 OPEN ENROLLMENT | 25BENEFITS ASSISTANCE
Member Advocacy
Employee benefits can be complex, making it difficult
to fully understand your coverage and use it properly.
Member Advocacy allows you to speak to a specially
trained Member Advocate, who can answer your
questions and help you get the most out of your
benefits.
You Can Contact Member Advocacy for
Assistance if You:
Believe your claim was not paid properly
Need clarification on information from the insurance
company
Have a question regarding a bill from a doctor, lab
or hospital
Are unclear on how your benefits work
Need information about adding or deleting a dependent
Need help to resolve a problem you’ve been working on
How To Contact Member Advocacy?
You may contact the Member Advocacy Team in any
of the following ways:
Via phone: 800.563.9929, Monday through
Friday, 8:30 am to 5:00 pm (Eastern Time)
Via the web: www.connerstrong.com/
memberadvocacy
Via fax: 856.685.2253
26 | ARCADIA UNIVERSITYIMPORTANT CONTACT INFORMATION
For your convenience, below is a list of important contacts for all of your Arcadia University employee benefits needs.
BENEFIT PLAN CARRIER PHONE NUMBER WEBSITE
Medical, Prescription Drug Independence
800.ASK.BLUE www.ibx.com
and Vision Blue Cross
Flexible Spending Accounts PayFlex 844.PAY.FLEX www.payflex.com/individuals
Healthcare Spending
Health Equity 866.346.5800 www.healthequity.com
Account (HSA)
Voluntary Vision Vision Service Plan 800.877.7195 www.vsp.com
Dental Cigna 800.CIGNA.24 www.cigna.com
Life & Disability insurance Cigna 800.362.4462 www.cigna.com
Retirement TIAA 800.842.2888 www.tiaa.org/arcadia
Cigna Secure Travel Cigna 888.226.4567 N/A
Accident & Hospital Stay Cigna 800.362.4462 www.cigna.com
Pet Insurance Figo 844.738.3446 www.figopetinsurance.com
Employee Assistance www.myliferesource.com
Carebridge 800.437.0911
Program Access Code: 6CSKH
www.connerstrong.com/
General Benefit Questions Member Advocacy 800.563.9929
memberadvocacy
Benefits Assistance PlanSource Call Center 866.364.9717 benefits.plansource.com
Please contact the following Human
Resources Representatives with
any benefit-related questions:
Sacha Mendez...........215.572.2173
HR Main...................215.572.2173
Brian French.............215.572.2788
2020-21 OPEN ENROLLMENT | 27You can also read
